Lundbeck has issued a ‘Dear Healthcare Professional’ letter in conjunction with the MHRA informing healthcare professional of the following new safety information on escitalopram (Cipralex™) – see letter attached.

• Escitalopram is associated with dose dependant QT interval prolongation.

• In elderly patients >65 years old the maximum dose of escitalopram is now reduced to 10mg daily.

• The maximum dose of escitalopram for adults <65 years remains 20mg daily.

• Escitalopram is contraindicated in patients with known QT interval prolongation or congenital long QT syndrome

• Use of escitalopram with other medicinal products known to prolong the QT interval is contraindicated.

• Caution is advised in patients at higher risk of developing torsade de pointes, for example those with uncompensated heart failure, recent myocardial infarction, Brady arrhythmias or a predisposition to hypokalaemia or hypomagnesaemia because of concomitant illness or medicines.

• Patients should be advised to contact a healthcare professional immediately if they experience an abnormal heart rate o rhythm while taking escitalopram.

The MHRA has already issued these safety warnings in its Drug Safety Update - see NELM abstract below.